Table of Contents

  1. Introduction
  2. Executive Summary
  3. Section 1: Opioids, Opioid Use Disorder and MOUD
  4. Section 2: MOUD Availability in Jails Nationwide and in NC
  5. Section 3: NC Jails Discussion: barriers to MOUD treatment and problems with existing programs
  6. Section 4: Recommendations and Resources

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North Carolina is facing an overdose crisis where our loved ones, friends, and neighbors are being tragically taken away from us. These are also individuals we interact with daily in our communities, from our places of worship to our schools and workplaces. Despite having effective tools like Medications for Opioid Use Disorder (MOUD) within our reach, we’re failing to provide access to them.

This extends to NC’s jails. In large part due to the inadequacy of community services, people with disabilities, including those with Opioid Use Disorder (OUD), are overrepresented in NC jails and prisons. In 2023, Disability Rights North Carolina (DRNC), the state’s Protection and Advocacy organization charged with safeguarding the legal rights and lives of nearly 3 million North Carolinians with disabilities, began an in-depth look at the availability of MOUD in NC jails.

OUD is not merely a personal struggle; it’s a medical condition and a disability. There are legal bases to require that MOUD be provided to people with OUD in our jails (and prisons): the US Constitution and the Americans with Disabilities Act (ADA). Under the ADA, people with disabilities are safeguarded from discrimination. Denying access to medications for treating OUD is a form of discrimination.

DRNC, a leading advocate for people with disabilities, has federally granted access authority to obtain information affecting disabled people who are jailed in all North Carolina’s 100 counties. As DRNC gathered information, we also provided education and information to people with disabilities who experienced discrimination and to the sheriffs, their staff, other county employees, and community providers.

There are three FDA-approved medications designed to address OUD, with methadone and buprenorphine emerging as the most effective. Methadone and buprenorphine not only treat the disorder – they also significantly reduce the risk of fatal overdoses and the return to illicit drug use and increase the likelihood of remaining in treatment. By providing access to these medications, we offer individuals struggling with OUD the chance to heal and rebuild their lives. Denying them this opportunity is to rob them of a future that’s within their grasp.

Jails have a unique opportunity to provide access to critically needed MOUD and have a major impact on NC’s overdose death crisis. While some jails are providing this lifesaving treatment in their facilities, others are not. Providing these medications is a best practice for our communities and puts NC on the right track to stop the overdose death crisis.

Our report Saving Lives: Ensuring Access to Medications for Opioid Use Disorder (MOUD) in NC Jails provides a detailed look into the issues of opioids and MOUD, DRNC’s findings, barriers and problems within NC jails, helpful resources, and actionable recommendations for change. We hope you will read this report and join DRNC in working towards progress that we believe will save lives and make our communities stronger.

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